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What Is a Stellate Ganglion Block?

A stellate ganglion block is an image-guided injection of local anesthetic near the cervical sympathetic chain in the lower neck. The target is the stellate ganglion region, which carries sympathetic nerve signals to parts of the head, neck, chest, and upper extremity. Temporarily interrupting these signals can help diagnose or treat sympathetically maintained pain and selected vascular or autonomic conditions. The procedure is different from surgical removal of a nerve and usually produces a temporary sympathetic block.

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What Is a Stellate Ganglion Block?

A stellate ganglion block is an image-guided injection of local anesthetic near the cervical sympathetic chain in the lower neck. The target is the stellate ganglion region, which carries sympathetic nerve signals to parts of the head, neck, chest, and upper extremity. Temporarily interrupting these signals can help diagnose or treat sympathetically maintained pain and selected vascular or autonomic conditions. The procedure is different from surgical removal of a nerve and usually produces a temporary sympathetic block.

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Why Is a Stellate Ganglion Block Performed?

The procedure is commonly used for selected patients with complex regional pain syndrome or other sympathetically maintained pain involving the upper extremity. It can also be used for certain vascular conditions such as Raynaud syndrome or upper-extremity ischemic pain and for selected refractory pain syndromes. A diagnostic block can help determine whether sympathetic activity contributes to a patient's symptoms before additional treatment is considered. The indication should be individualized because evidence and accepted use vary substantially among the many conditions for which stellate ganglion block has been studied.

How Is a Stellate Ganglion Block Performed?

The patient lies on the back while the neck is positioned to expose the injection area. Ultrasound or fluoroscopic guidance is used to identify the cervical anatomy and guide a needle near the sympathetic chain while avoiding major blood vessels, the airway, and other nerves. After careful positioning and aspiration checks, a small amount of local anesthetic is injected around the target tissue. Temporary warmth in the arm and signs such as eyelid drooping or a smaller pupil on the treated side can indicate sympathetic blockade.

What Is Recovery Like After a Stellate Ganglion Block?

Patients are observed after the injection until breathing, swallowing, blood pressure, and neurologic status are stable. Temporary Horner syndrome, warmth of the face or arm, hoarseness, throat fullness, or mild swallowing difficulty can occur as the anesthetic spreads. These effects generally resolve as the local anesthetic wears off over several hours. Activity and driving restrictions depend on sedation, visual symptoms, arm weakness, and the instructions of the treating pain specialist.

What Are the Risks and Complications?

Possible complications include bleeding, infection, vascular puncture, hoarseness, temporary swallowing difficulty, and unintended brachial plexus or phrenic nerve block. Accidental injection into a blood vessel can cause local-anesthetic toxicity, seizures, or cardiovascular complications. Rare serious events include pneumothorax, spinal or epidural spread, nerve injury, and a neck hematoma that can threaten the airway. Image guidance and careful attention to anticoagulation, anatomy, monitoring, and resuscitation readiness reduce procedural risk.

Frequently Asked Questions About Stellate Ganglion Block

Does a stellate ganglion block cause Horner syndrome?

Temporary Horner syndrome can occur after a successful block and can include a drooping eyelid, smaller pupil, and reduced sweating on the treated side.

How long does a stellate ganglion block last?

The local-anesthetic block itself is temporary and commonly lasts hours. Pain relief can last longer in some patients, and a series of blocks can be considered depending on the condition and response.

Is ultrasound used for stellate ganglion block?

Yes. Ultrasound is commonly used to visualize soft tissues, blood vessels, and the needle path. Fluoroscopy is another image-guidance option.

Can a stellate ganglion block treat complex regional pain syndrome?

Yes. It is one interventional option for selected patients with sympathetically maintained pain or complex regional pain syndrome involving the upper extremity.

References

Stellate Ganglion Block: What It Is, Uses, Side Effects & Risks. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/17507-stellate-ganglion-block. Date Accessed September 11, 2026.

Stellate Ganglion Blocks. StatPearls (NCBI Bookshelf). https://www.ncbi.nlm.nih.gov/books/NBK507798/. Date Accessed September 11, 2026.

Neuroanatomy, Stellate Ganglion. StatPearls (NCBI Bookshelf). https://www.ncbi.nlm.nih.gov/books/NBK539807/. Date Accessed September 11, 2026.

Complications associated with stellate ganglion nerve block: a systematic review. PubMed. https://pubmed.ncbi.nlm.nih.gov/30992414/. Date Accessed September 11, 2026.

Ultrasound-guided stellate ganglion block: safety and efficacy. PubMed. https://pubmed.ncbi.nlm.nih.gov/24760493/. Date Accessed September 11, 2026.